Organization
DAVID J. SMITH MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID J SMITH M.D. (PRESIDENT)
(517) 627-2181
Entity
Organization
Contact information
Practice address
1035 CHARLEVOIX DR STE 100, GRAND LEDGE, MI 48837-2223
(517) 627-2181
(517) 622-1242
Mailing address
1035 CHARLEVOIX DR STE 100, GRAND LEDGE, MI 48837-2223
(517) 627-2181
(517) 622-1242
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
6401007475
MI
207Q00000X
Family Medicine Physician
Primary
DS030055
MI
363LF0000X
Family Nurse Practitioner
4704208405
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080B360240
BCBSM GROUP NUMBER
MI
01
—
C1769
MEDICARE RAILROAD
—
Enumeration date
01/16/2007
Last updated
12/11/2017
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